Korean J Urol Oncol.  2017 Dec;15(3):143-151. 10.22465/kjuo.2017.15.3.143.

Clinicopathologic and Oncological Outcomes in Korean Men With Advanced Metastatic Testicular Cancer Undergoing Postchemotherapeutic Retroperitoneal Lymph Node Dissection

• Yuk HD
• Kang M
• Lee JK
• Hong SK
• Ku JH
• Byun SS
• Kwak C
• Kim HH
• Lee SE
• Jeong CW

• KMID: 2402596
• DOI: http://doi.org/10.22465/kjuo.2017.15.3.143

Abstract

PURPOSE
To evaluate the clinicopathologic and oncological outcomes of advanced metastatic testicular cancer in Korean men who underwent retroperitoneal lymph node dissection (RPLND) following chemotherapy.
MATERIALS AND METHODS
Data of 26 patients with testicular cancer who underwent RPLND after chemotherapy at 2 hospitals in Korea between September 2004 and June 2016 were retrospectively analyzed. Clinical and histopathological variables such as stage of the testicular cancer, age of the patients during surgery, size of the retroperitoneal lymph nodes (RPLNs), histopathological results, duration and complications related to the surgery, cancer recurrence, and mortality were analyzed.
RESULTS
During testicular surgery, the T stage was pT1, pT2, and pT3 in 50% (n=13), 26.9% (n=7), and 15.3% (n=4) of the patients, respectively. Mixed germ cell tumor was the most common finding, seen in 73.1% (n=19) of patients. The indications for RPLND were residual lymph nodes after chemotherapy, 84.6% (n=22); and disease progression and remission, 7.7% (n=2). Pathological analysis revealed viable tumors in 19.2% of patients (n=5), necrotic/fibrotic tissue in 42.3% (n=11), and teratoma in 34.6% (n=9). Intraoperative and postoperative complications occurred in 23.1% (n=6) and 19.2% of patients (n=5). The median duration of follow-up was 27.5 months (interquartile range, 1.3-108.2 months); 11.5% (n=3) patients had recurrence, and 3.8% (n=1) died of progressive metastatic testicular cancer.
CONCLUSIONS
Viable germ cell tumors were present in 19.2% of patients with testicular cancer who underwent RPLND after chemotherapy. This is the first study of its kind in the Korean population.

Keyword

Testicular germ cell tumor; Postoperative complications; Lymph node excision

MeSH Terms

Disease Progression
Drug Therapy
Follow-Up Studies
Humans
Korea
Lymph Node Excision*
Lymph Nodes*
Male
Mortality
Neoplasms, Germ Cell and Embryonal
Postoperative Complications
Recurrence
Retrospective Studies
Teratoma
Testicular Neoplasms*